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Published on: December 13, 2017
Tremors: Essential Tremor and Beyond
Chandrabhaga Miskin1, Karen S Carvalho2
1Division of Pediatric Neurology, Saint Peter's University Hospital, New Brunswick, NJ.
Insights
Pediatric tremor, a common movement disorder, requires careful evaluation of its characteristics, associated symptoms, and medication effects for accurate diagnosis and management. Effective pharmacologic treatments for tremor remain challenging, necessitating a comprehensive approach.
Area of Science:
- Pediatric Neurology
- Movement Disorders
Background:
- Tremor is a frequent presenting complaint in pediatric neurology.
- Tremors can stem from primary causes or secondary to systemic/neurologic conditions.
Purpose of the Study:
- To review the clinical examination, classification, and diagnosis of pediatric tremor.
- To outline the pathophysiology and discuss treatment options for various tremor forms.
Main Methods:
- Review of clinical examination techniques for tremor assessment.
- Classification systems for pediatric tremors.
- Discussion of diagnostic criteria and differential diagnoses.
- Overview of pathophysiologic mechanisms.
- Evaluation of current pharmacologic and non-pharmacologic treatment strategies.
Main Results:
- Accurate classification is crucial for diagnosis and management.
- Phenomenology, associated neurologic signs, and medication influences are key assessment components.
- Objective assessment of tremor severity and functional impairment guides treatment decisions.
Conclusions:
- Effective pharmacologic treatment for pediatric tremor is often disappointing.
- A thorough clinical evaluation, precise classification, and consideration of functional impact are essential for optimal patient care.
- Further research into more effective therapeutic interventions is warranted.
Abstract:
Tremor is a fairly common movement disorder presenting to an outpatient pediatric neurology practice. Tremors can be primary or secondary to underlying neurologic or systemic diseases. When assessing a child with tremor, it is paramount to evaluate the phenomenology of the tremor, determine the presence or absence of other neurologic signs and symptoms, and the possible modifying influence of medications. Proper classification is essential for specific diagnosis and prompt adequate management. Treatment considerations should take into account objective assessment of tremor severity and the degree of disability or impairment experienced by the child. Overall effectiveness of pharmacologic treatments of tremor is unfortunately disappointing. In this article we review the clinical examination, classification, and diagnosis of tremor. The pathophysiology of the different forms of tremor is outlined, and treatment options are discussed.
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